METHODS: One million T2D people aged 40-79 registered in the National Diabetes Registry (2009-2018) were linked to death records (censored on 31 December 2019). Standardized absolute mortality rates and standardized mortality ratios (SMRs) were estimated relative to the Malaysian general population, and standardized to the 2019 registry population with respect to sex, age group, and disease duration.
RESULTS: Overall all-cause standardized mortality rates were unchanged in both sexes. Rates increased in males aged 40-49 (annual average percent change [AAPC]: 2.46 % [95 % CI 0.42 %, 4.55 %]) and 50-59 (AAPC: 1.91 % [95 % CI 0.73 %, 3.10 %]), and females aged 40-49 (AAPC: 3.39 % [95 % CI 1.32 %, 5.50 %]). In both sexes, rates increased among those with 1) > 15 years disease duration, 2) prior cardiovascular disease, and 3) Bumiputera (Malay/native) ethnicity. The overall SMR was 1.83 (95 % CI 1.80, 1.86) for males and 1.85 (95 % CI 1.82, 1.89) for females, being higher in younger age groups and showed an increasing trend in those with either > 15 years disease duration or prior cardiovascular disease.
CONCLUSIONS: Mortality trends worsened in certain T2D population in Malaysia.
METHODS: Patients were grouped according to the histopathological examination results: (i) BTG patients (n = 9), (ii) PTC patients without BTG background (PTCa, n = 8), and (iii) PTC patients with BTG background (PTCb, n = 5). Whole-exome sequencing (WES) was performed on genomic DNA extracted from thyroid tissue specimens. Nonsynonymous and splice-site variants with MAF of ≤ 1% in the 1000 Genomes Project were subjected to principal component analysis (PCA). PTC-specific SNVs were filtered against OncoKB and COSMIC while novel SNVs were screened through dbSNP and COSMIC databases. Functional impacts of the SNVs were predicted using PolyPhen-2 and SIFT. Protein-protein interaction (PPI) enrichment of the tumour-related genes was analysed using Metascape and MCODE algorithm.
RESULTS: PCA plots showed distinctive SNV profiles among the three groups. OncoKB and COSMIC database screening identified 36 tumour-related genes including BRCA2 and FANCD2 in all groups. BRAF and 19 additional genes were found only in PTCa and PTCb. "Pathways in cancer", "DNA repair" and "Fanconi anaemia pathway" were among the top networks shared by all groups. However, signalling pathways related to tyrosine kinases were the most significantly enriched in PTCa while "Jak-STAT signalling pathway" and "Notch signalling pathway" were the only significantly enriched in PTCb. Ten SNVs were PTC-specific of which two were novel; DCTN1 c.2786C>G (p.Ala929Gly) and TRRAP c.8735G>C (p.Ser2912Thr). Four out of the ten SNVs were unique to PTCa.
CONCLUSION: Distinctive gene mutation patterns detected in this study corroborated the previous protein profile findings. We hypothesised that the PTCa and PTCb subtypes differed in the underlying molecular mechanisms involving tyrosine kinase, Jak-STAT and Notch signalling pathways. The potential applications of the SNVs in differentiating the benign from the PTC subtypes requires further validation in a larger sample size.
MATERIALS AND METHODS: A retrospective cohort study was conducted involving 592 prediabetic adults from 28 health clinics in Terengganu between January 2019 and June 2023. Participants were selected based on oral glucose tolerance test (OGTT) results indicating prediabetes. Sociodemographic, medical background, and clinical data, including body mass index (BMI), blood pressure, fasting blood sugar (FBS), and lipid profiles, were extracted from medical records. Glycaemic outcomes were classified into three categories: reversion to normoglyacemia, persistent prediabetes, or progression to DM, based on glycated haemoglobin (HbA1c) levels taken within two years of follow-up. Ordinal logistic regression analysis was used to identify the significant predictors influencing these outcomes.
RESULTS: Analysis showed age, BMI, underlying dyslipidaemia, FBS, and triglyceride levels as significant predictors of glycaemic progression. Specifically, each additional year of age and each one-unit increase in BMI raised the likelihood of progression to DM by 3% and 6%, respectively. Participants with dyslipidaemia were noted to have a 67% higher risk of worsening glycaemic status, while increases in FBS and triglyceride levels were associated with 65% and 34% greater odds of diabetic progression, respectively.
CONCLUSION: This study identifies critical predictors of glycaemic outcomes in prediabetic adults, emphasizing the role of age, BMI, dyslipidaemia, FBS, and triglycerides in the disease progression. These findings support the development of targeted interventions that address these risk factors to curb diabetes progression in high-risk individuals, contributing valuable insights into diabetes prevention strategies tailored for Malaysian populations.
METHODS: In this non-randomized pilot study, [99mTc]NaTcO4 gastric SPECT/CT (250 mL protocol) and proximal gastric HRM-NDT (~60 mL/min protocol) were performed separately within 30 days using Ensure Gold test meal (1.05 kcal/mL; Abbott). GA parameters were measured, and their preliminary associations were examined using Spearman's ρ and Hoeffding's D correlation tests. Data were presented as median ± normalized median absolute deviation.
KEY RESULTS: Twenty healthy, asymptomatic individuals (11 females; 23.5 ± 2.2 years, 23.7 ± 2.2 kg/m2) completed both procedures without serious adverse events and interrupted sessions. The accommodation volume and postprandial-to-fasting volume ratio from SPECT/CT were 325.8 ± 28.5 mL and 5.31 ± 1.28, respectively. During HRM-NDT, the nadir-intragastric pressure (IGP) was -6.6 ± 3.6 mmHg at an ingested volume of 360.0 ± 177.9 mL, and the area-under-curve of IGP was -1566.0 ± 1596.8 mmHg·mL. The maximum tolerated volume for reaching satiety/maximum discomfort was 450.0 ± 177.9 mL, and the area-under-curve of satiation score was 900.0 ± 266.9 satiation-unit·mL. The area-under-curve of IGP showed significant associations with maximum tolerated volume (ρ: -0.702; D: 0.234) and the area-under-curve of satiation score (D: 0.119): all p
METHODS: A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis.
RESULTS: The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference -0.24%; 95% confidence interval [CI]: -0.44, -0.05; p = 0.01), postprandial blood glucose (-2.91 mmol/L; 95% CI: -4.78, -1.03; p = 0.002), and triglycerides (-0.09 mmol/L; 95% CI: -0.17, -0.02; p = 0.010), but not on low-density lipoprotein cholesterol (-0.06 mmol/L; 95% CI: -0.14, 0.02; p = 0.170), high-density lipoprotein cholesterol (0.05 mmol/L; 95% CI: -0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure -0.82 mm Hg; 95% CI: -4.65, 3.00; p = 0.670; diastolic blood pressure -1.71 mmHg; 95% CI: -3.71, 0.29; p = 0.090).
CONCLUSIONS: Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.